AHRI.IsisekeloSempilo.Endline.Recruitment.Datasets
Isisekelo Sempilo:Endline recruitment of participants
Name | Country code |
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South Africa | ZA |
Background
Antiretroviral therapy (ART) through universal test and treat (UTT) and HIV pre-exposure prophylaxis (PrEP) substantially reduces HIV-related mortality, morbidity and incidence. Effective individual-level prevention modalities have not translated into population-level impact in southern Africa due to sub-optimal coverage among adolescents and youth who are hard to engage. We aim to investigate the feasibility, acceptability, and preliminary population level effectiveness of HIV prevention services with or without peer support to reduce prevalence of transmissible HIV amongst adolescents and young adults in KwaZulu-Natal.
Methods
A 2x2 factorial randomised controlled trial among young men and women aged 16-29 years, randomly selected from the Africa Health Research Institute demographic surveillance area. Participants are randomly allocated to one of four intervention combinations: 1) Standard of Care (SOC): nurse-led services for HIV testing plus ART if positive or PrEP for those eligible and negative; 2) Sexual and Reproductive Health (SRH): Baseline self-collected vaginal and urine samples with study-organized clinic appointments for results, treatment and delivery of HIV testing, ART and PrEP integrated with SRH services; 3) Peer-support: Study referral of participants to a peer navigator to assess their health, social and educational needs and provide risk-informed HIV prevention, including facilitating clinic attendance; or 4) SRH + peer-support.
The primary outcomes for effectiveness are: (1) the proportion of individuals with infectious HIV at 12 months and (2) uptake of risk-informed comprehensive HIV prevention services within 60 days of enrolment. At 12 months, all participants were contacted at home and the study team will collect a dried blood spot for HIV ELISA and HIV viral load testing.
Discussion
This trial will enable us to understand the relative importance of SRH and peer support in creating demand for effective and risk informed biomedical HIV prevention and preliminary data on their effectiveness on reducing the prevalence of transmissible HIV amongst all adolescents and youth.
Trial Registry: clincialtrials.gov
Trial registration: NCT04532307
<https>
Registered: March 2020
Survey data, census/enumeration data, agreegate data, event/transaction data, program source code, machine-readable text, administrative records data, experimental data, psychological test, textual data, coded textual, coded documents, budget diaries, observation data/ratings, process-produced data, etc. No description just a single phrase, e.g., Genetic sequences
Basic unit(s) of analysis or observation that the study describes: For PANGEA is each record a sequence from a specimen, or are there multiple records for a single specimen or study participant
V1.0.0
Demographic surveillance area of the Africa Health Research Institute; KwaZulu-Natal, uMkhanyakude district
We conducted a 2x2 factorial design intervention pilot trial including 1700500 men and women aged 16-29-years old and living in the AHRI surveillance area. The study duration was 18 28 months. Participants are randomly allocated to one of four intervention combinations: 1) Standard of Care (SOC): nurse-led services for HIV testing plus ART if positive or PrEP for those eligible and negative; 2) Sexual and Reproductive Health (SRH): Baseline self-collected vaginal and urine samples with study-organized clinic appointments for results, treatment and delivery of HIV testing, ART and PrEP integrated with SRH services; 3) Peer-support: Study referral of participants to a peer navigator to assess their health, social and educational needs and provide risk-informed HIV prevention, including facilitating clinic attendance; or 4) SRH + peer-support.
For our primary outcomes of interest, 1) the proportion of individuals with infectious HIV at 12 months and (2) uptake of risk-informed comprehensive HIV prevention services within 60 days of enrolment. we assessed uptake of comprehensive HIV prevention services, including Pre-Exposure Prophylaxis (PrEP) and Universal Test and Treat (UTT) and the reduction of the proportion of individuals at a population level with infectious HIV (population viral load).
Over a period of 12 months after enrolment and randomisation we collected routine data on uptake of Thetha Nami and Clinical Services as well as adverse events. At 12 months following enrolment we approached all those who were enrolled consented at endline by phone, in their homes or wherever they preferred to be seen. Following Informed Consent, we conducted a brief redcap survey to collect information on uptake and experience of HIV prevention and care services, uptake of contraception and incidence of pregnancy, mental health (using PHQ9), and quality of life. We also offered point of care HIV testing and linkage to care, collect dry blood spot for HIV ELISA and HIV viral load, and offered STI testing and treatment to all.
Throughout the study In addition, we conducted a mixed-method process evaluation to collect data on uptake and retention and fidelity of each component of the intervention; assess service users and providers and the community experience, i.e. which facets of the package are valued; and any social harms. A costing analysis will be undertaken to establish the cost of delivering the intervention through the different models of care.
Name | Affiliation |
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Prof Maryam Shahmanesh | Africa Health Research Institute (AHRI) |
Name |
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Africa Health Research Institute |
Name | Role |
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3ie | Funder |
Nationational Institute of Health | Funder |
Name | Affiliation | Role |
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Jaco Dreyer | Africa Health Research Institute | Data management, cleaning and analysis |
We use the AHRI demographic surveillance as a sampling frame to select a random sample of 3000 men and women aged 16-29 years old, stratified by sex, and invite them to participate in the study. Individuals are eligible to enrol in the study if they are between 16-29 years old, resident in the surveillance area, willing and able to provide informed consent, willing to be followed up at 12 months, and willing to provide a dried blood spot (DBS) for anonymous HIV testing and HIV viral load measurement at 12 months. Based on previous studies in this setting, we expected that 2000 will be contactable and eligible, and 1500 (75%) will enrol. In fact we enrolled 1743.
Start | End |
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2021-09-16 | 2022-06-05 |
The representative of the Receiving Organization agrees to comply with the following conditions:
DDI.AHRI.IsisekeloSempilo.Endline.Recruitment.Datasets
Name |
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Africa Health Research Institute |